Go together well

{Dad, third from right, breaking ground at the site of his clinic, ~1987.} On June 24, I graduated from family medicine residency and became the fourth family physician/general practitioner in three generations of Dorwarts. A week later, on July 1, our family gathered in Sidney, Nebraska, to celebrate my dad's retirement after 35 years as a family physician there. I couldn't be prouder of the work my dad has done throughout his career, his dedication to our hometown, his persistence through difficult times, and his unwavering insistence on doing the right thing even when it's not the easy thing. Even though I considered forays into surgery and gynecologic oncology (among other things), I am happy to have found my way to family medicine and to my father's footsteps. Although my dad worked long hours throughout my childhood, I never felt like I was missing out because I appreciated the importance of what he was doing. My perception was that he was spending his d...

After a couple of weeks of rounds with "the Zvandasara firm" (they refer to teams of doctors as firms, which makes me feel like I'm in a John Grisham novel) and delivering babies with the midwives, Dave and I are hitting our stride and understanding (at least at a basic level) how things work here. We continue to be amazed by the number of babies born at Harare Central Hospital every single day, and we are relishing the opportunities and experiences we’re gaining. {Me with a baby I just delivered and dressed in a very warm outfit!} Although it is no surprise that there is significant poverty in Zimbabwe (after all, it is a developing nation ), I have been struck by the dramatic ways in which the scarcity of jobs and resources affect people’s health. A recurring theme in gynecology clinic is: woman diagnosed with cancer (or probable cancer) a year ago, did not have the recommended treatment at that time because of inability to pay for it, now returning after havi...

It’s been a week since we (my fellow UVM resident, Dave, and I) arrived via a bumpy landing at Harare International Airport to start a month-long obstetrics rotation at one of Zimbabwe’s tertiary medical centers. At times cautiously navigating a foreign system and at others readily integrating into seemingly universal medical practices (daily rounds, admissions, systematic gathering of patient data), we are learning that being a doctor in Zimbabwe is in some ways unrecognizably distinct and in others comfortable, familiar.  Before I go further, I want to clarify something: throughout my preparations for this trip, I received a lot of undue praise from friends, family, and patients about how great it is that I would travel to Zimbabwe for a "medical trip," with the assumption being that I am somehow going to accomplish something great or to "save" people from death or illness. While I would love to be able to end vertical HIV transmission or to vaccinate eve...

I started on my labor and delivery (L&D) rotation last Thursday--and it has been challenging, to say the least. The most difficult part of L&D also happens to be the part on which everything else hinges: the cervical check. Deciding whether to admit a patient? Do a cervical check! Wondering if it's time to call the anesthesiologist for an epidural? Check the cervix! Questioning the progress of labor? Cervix! Why is this such a problem? Imagine introducing yourself for the first time to a woman who (at worst) is screaming and writhing in pain and (at best) is extremely uncomfortable, then saying, "I'll need to check your cervix." Translation: We just met, and you have a human being trying to escape from your body...but can you please get in a frog-leg position so that I can stick my hand in your vagina?  Not only is it painful for the soon-to-be mom, but given my lack of experience with palpating squishy objects that are hidden from my vision in narrow spaces...